Bottom-up Disaster Relief: How to Help Haiti Help Itself

On June 3, Propublica released a report on the American Red Cross’s Haiti relief efforts, attracting widespread attention, concern, and criticism. Titled “How the Red Cross Raised Half a Billion Dollars for Haiti and Built Six Houses,” the report contains serious allegations of fund mismanagement, lack of transparency, and, ultimately, a complete failure to deliver on promises of long-term housing solutions for those displaced by the earthquake. This piece joins a growing body of investigative journalism – with other notable entries including a recent VICE episode/article and Jonathan Katz’s fine book The Big Truck That Went By – that raises profound, troubling questions about the way that the international aid system operates, both in Haiti and globally.  

 Regrettably, Haiti has all too often served as a ready example of the ways that the international aid system has failed those it is intended to serve.  Long nicknamed “The Republic of NGOs,” Haiti attracted substantial international relief effort and aid money well before the earthquake, and received an unprecedented $16 billion in pledged aid after the earthquake. In the aftermath of the earthquake, the international community pledged lasting and meaningful change in Haiti, with words like sustainability and partnership entering the buzz-vernacular.

Yet, today, the country and its people do face many of the same profound infrastructure-level problems that plagued it before January 2010, as these reports make clear. The recent claims concerning the Red Cross’s shortcomings – excessive overhead costs; hiring preferences towards non-Haitian staff; unfamiliarity with Haitian culture and languages; inexperience with local context and the land deed system – are problems that have surfaced for many well-intentioned organizations in Haiti.  It’s indisputable that, for all of the international community’s good intentions, many post-earthquake efforts have been characterized by a lack of commitment to genuine collaboration with and support of local partners.  

All of this being the case, it’s reasonable to wonder how one can be sure that one’s well-intentioned donation to an international aid or development organization will have the intended impact. Indeed, in light of these failures to “fix” Haiti, it may be tempting to withdraw from the issue and to withhold support altogether. However, this is not the answer.

Despite the geopolitical and human factors that have limited progress in Haiti, we must not forget some of the significant success stories that NGOs have been a part of. The construction of the Hôpital Universitaire de Mirebalais (HUM) after the earthquake has provided vitally important care to patients in the Central Plateau and around the country. Beyond setting a new high standard for teaching hospitals in Haiti, HUM embodies an admirable example of cooperation between nonprofits and the Haitian government.

Supporting the development of truly Haitian-devised, Haitian-led solutions is vital to breaking the cycle of dependency on aid and misdirection of funds that have all too often been the legacy of aid efforts there. It is imperative that NGOs adopt an inclusive, transparent, and pragmatic approach to advancing their efforts and supporting the Haitian people. We believe that smaller nonprofits, which are often free from some of the bureaucratic and financial entanglements that come with large budgets, are often in the best position to tap into local resources and truly listen – and genuinely partner with – those they wish to serve.

At EqualHealth, we focus on investing in Haiti’s human potential. Since 2010, we have been providing the medical resources, training opportunities, and support that Haitian health professionals – those most aptly positioned to impact Haiti in a durable manner – need to take the best possible care of their patients. We work with minimal overhead, and invest in our programs shrewdly. We are proud of the fact that, when the value of donated volunteer services and in-kind donations is taken into account, 94% of our expenses are directly invested into our programs. We employ only one international staff member, and rely on a large network of capable volunteers and a dynamic Haitian team to provide the necessary manpower. Notably, we are inherently partner-driven: each of our programs is designed at the request of, and in collaboration with, the Haitian institutions that will implement them.

Our flagship Teach the Teacher program, based at the aforementioned HUM, is a prime example of this. Developed in response to our colleagues’ consistent requests for additional clinical-educator training, this year-long curriculum has – within its first year – been officially adopted by HUM and endorsed by the Haitian Academic Directorate. These are key steps toward ensuring that this critical training remains a part of the curriculum for medical and nursing leaders in Haiti, and our objective is to gradually transfer the program’s reins to the hands of our Haitian medical colleagues.

Meaningful development in Haiti is achievable – indeed, we see it happening every day. But collaboration with our Haitian colleagues is absolutely essential to this, and that is why we are dedicated to supporting their efforts to build a stronger and healthier medical infrastructure in Haiti

We believe that, in the end, the role of foreign aid should not be to save or fix Haiti, but rather to provide Haitians with equal access to resources, resilient structures, and opportunities so that they can lead the push to build a stronger, healthier Haiti – is there anything foreign about that?  

We invite you to explore our work and our finances to learn more.


Additional reading:

 -The Red Cross’s official response to the original article

-An interview with co-author Laura Sullivan on the investigation